Claim total
$292.91
base $93.39 · payer covered $242.91
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bronchitis10509002
- Start
- 2015-01-08
- Stop
- 2015-01-08
The parties
- Patient
- patient Sylvie Loma Bailey
- Provider
- provider Burton O'Conner
- Payer
- payer Medicaid
Record id
10d68dd4-2444-6d0f-0365-29d5a68f1c59